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Miscellaneous - 105 MASSACHUSETTS AVENUE 4/30/2018
N o 1 O � 0) O O n cn O = O C N m O-1 O cn O � o m z m m Department of Public Health & Department of Labor IMC NOTIFICATION OF DELEADING WORK nl [-C All sections of this form must be completed in order to comply wit the notification requirements of M.G.L. C. 111§197, ��= l 454 CMR 22.00 and 105 CMR 460.000, as most recently amended Contractor performing project Chris ZOrZy License # DC000440 Exp. Date 6/7/2014 Lead Paint Inspector Dennis Daly Date of Inspection 10/30/2013 ' License # 1908 Exp. Date ADDRESS OF PROJECT: RECEIVED DEC -1 *1 2013 TOWN Ut- NOW, H ANDOVER HEA LTHDEPA�NT Street Address 119-121 Massachusetts Avenue Apt. Number City. North Andover Zip 01845 Property Owner Bruce Von Oesen, Pete Rawlings Address 105 Massachusetts Ave, No. Andover Telephone Number 978-688-2888 Deleading Method: Wet/Dry Scraping ❑ Heat Gun ❑ Liquid Encapsulant []Demolition ❑ Caustics Replacement OCovering ❑ Other If "Other" selected, please explain Check one: Dwelling is multi -family Single-family= Other_ Start Date 12/23/2013 Completion Date 1/2/2014 When will work be done: AM X PM X (Specify times on site) Weekends? Project Supervisor Name Willie Woods License # DS3534 Exp. Date 11 /5/2014 Worker's Compensation Policy Number 02431VI815 Carrier Travelers In case of emergency contact Sean Luddy Tel. #_( 978 ) 741-0424 (Contractor's Representative) DELEADING CONTRACTOR The undersigned hereby.states, under the pains and penalties of perjury, that he/she has read and understood the Commonwealth of Massachusetts Deleading Regulations, 454 CMR 22.00, and the Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000, and that the information contained in this notification is true and corre% to the best of his/her., knowledee and belief. 12/11/2013 Company Name A & A Services, Inc. Address 115 North Street, Salem, MA 01970 Telephone Number 978-741-0424 OVER—'t BOARD OF HEALTH 120 MAIN STREET NORTH ANDOVER, MASS. 01845 APPLICATION FOR DUMPSTER PERMIT PURSUANT TO SECTION 31A AND 31B OF CHAPTER 111 OF THE GENERAL LAWS, AND RULES AND REGULATIONS OF THE NORTH ANDOVER BOARD OF HEALTH DATE Aug.7 0 1991 TO THE BOARD OF HEALTH: TEL: 682-6483 Ext. 32 or 33 Application is hereby made for a permit to maintain a dumpster on property located at 105 Mass Ave. North Andover, Ma. 01845 in accordance with the Rules and Regulations of the Board of Health Check use: ( ) Residential use ( X) Commercial use ( ) 30 day temporary ( ) Annual Name of applicant• North Andover Bldg. Center/DBA Mutabo Owner of property• Francis Tate, Bert Munro Telephone number: 685-1301 Inc. On the bottom half of this form, please sketch an outline of property, showing the proposed location of the dumpster. Give distance from dumpster to other buildings and lot lines or boundaries. Use back side if additional space is needed. Please return this application with a fee of $10.00 ($5.00 for temporary permit) to: Board of Health, 120 Main St., No. Andover, MA 01845. . F7;�� �. t- � � '.. U ABO INC. D/B/4:, . I '..... . 1. - §-w, k '�.�A T ,zv, CAl EA A PT % EW ll Io tNUhI !,�..H AN..�U!U,/,V L1,*,H �-• , 4 9Y-11N1,I)IINMASS 0184,5 ..�1i . - � .i , f,�,,�'�i!r!'�l,.�:, - 411. ,� —�. , . . j:"�j: Il�:!!!,.,.!���,.'',� -il -I I — .. :... L� ... . I , , . BUILDING SUPPLIES FOR THE "kD��4�,�N6.C6NiA�CTOR���,�.!�i�,'�.;�i:ili,�.��.;,I:�:, ii . , " �l .." : %:, 1-i '.�,� .... � I I . ", .,. - orll, �, ",:..�;�;-..;-: ,,, . I � ,�,-. � ..."'.- '.1 ..i% '-�; , , , �;, �. lll-.� ...... I, ,, - ... , .:., � .., i �� ,,;,," :,�, � 1. � -,� -�, , ,,�,,; , -* , ,.!: , . - �` . , , , ;., ,:,!,��,t�% , � . I , I � '1;.-::�--::;,lf. -..,..,... ;.':,,�;�(�:f""",�-1,4'", . ,;. ,. 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It"A f , �, � , . - . - � -., t � , ,. , , ? , � - "� I , 4 '. � . 1. . , � -11,�-llll � NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS 10.00 ......_..Town...------•----- of ---..North--Andover--------------------- This is to Certify that _.._.__No._ Andover Building Center d/b/a Mutabo, Inc. --•-•-•- •••-----------•--------••--------•-••----•......-•--•-•----•-. NAME -------------------....................................... --No_....AndDvez�..................................... ADDRESS IS HEREBY GRAINED A PERMIT Maintain one (1) Dumpster For --•--•-----------------•.•-•-•----._.....---_..:. ....._._....................................................:............................................................................................................... ............................................................................................................................................................................ This permit is granted in conforinity with the Statutes and ordinances relating thereto, and expires .._.......December -3-1,_..1991.................unless sooner suspended or revoked. Au ust 15,91 = .. ....! .. ............f,, - ..................•- trr't .. ............................... F 's � '� F -.. •�'' w ..tF � �' = ,y7 i " A � � t ; ;1't S'. z • f y 7 h". H k, l� y +.q '.a4✓' :. � Y' �� q 4� .�.' }; � w �. %�y� „p0 i 5 � :cS 1 � # � f: F n• nK d '�S. � } � � t � j ,v. '�+. F,. }� .t ham` :'L 9.y ') 'i � #:� F.l� � `;,° y y.� ? T• -r � •O7 �tf W �, �R , V i i r {4k1 Fl .0 }Ey hfiy 'qty .Lr -• ._ - .� .. V � �: 4 k BOARD OF HEALTH 120 MAIN STREET TEL: 682-6483 NORTH ANDOVER, MASS. 01845 Ext. 32 or 33 APPLICATION FOR DUMPSTER PERMIT PURSUANT TO SECTION 31A AND 31B OF CHAPTER 111 OF THE GENERAL LAWS, AND RULES AND REGULATIONS OF THE NORTH ANDOVER BOARD OF HEALTH DATE Dec. 11, 1991 TO THE BOARD OF HEALTH: Application is hereby made for a permit to maintain a dumpster on property located at 105 Mass Ave. North Andover, Ma. 01845 in accordance with the Rules and Regulations of the Board of Health r Check use: ( ) Residential use ( ) Commercial use ( ) 30 day temporary ( �) Annual Name of applicant: North'Andover Bldg. Center Owner of property: Francis Tate, Bert Munro Telephone number: 685-1301 On the bottom half of this form, please sketch an outline of property, showing the proposed location of the dumpster. Give distance from dumpster to other buildings and lot lines or boundaries. Use back side if additional :Dace is needed. Please return this application with a fee of $10.00 ($5.00 for temporary permit) to: Board of Health, 120 Main St., No. Andover, MA 01845. A NUMBER FEE THE COMMONWEALTH OF MASSACHUSETTS OWN $10.00 ........................... .... of __....................................................... ANDOVER -• •- -- -- -- •- •---.......--••---•-- This is to Certify that ................... orth_ Andover Building __Center NAME 105 Mass Avenue, North Andover, MA 01845 --•-•--------•----- ADDRESS IS HEREBY GRANTED A PERMIT For ................................Maintain One (1) Dumpster . ...--•--------------•--•-------------•----•--------------•-----•-••-•-•--•--••------ ------•---•---•--••--•---•--•---•-----------•--------•---•............................ ---------•---•---------•---•----•....................................................... This permit is granted in conformity with the Statutes and ordinances relating thereto, and expires..Decemher... 3.1.,_...1992................unless sooner suspe)3 evoked. .. .. . .R=P -...?.4 . =. Dezember 19 9 --�... �1 1%') /).. Y ;� t�C---------- --- FORM 481 HOBBS & WARREN, INC. C v 0 r r r 0 0 r Ul 0 0 r r r ru